First, scalpel

Correct blade handling method ( √ )

Four correct ways to hold a knife ( √ )

1. The bow type is the most commonly used type of knife. The range of motion is wide and flexible. The force involves the entire upper limb, mainly on the wrist. For longer skin incisions and incisions of the rectus abdominis anterior sheath.
2. The pen-type force is gentle, the operation is flexible and accurate, and it is easy to control the movement of the knife. The action and strength are mainly on the finger. For short incisions and fine surgery, such as dissecting blood vessels, nerves and incision of the peritoneum.
3. Hold the handle with the whole hand, and thumb and finger to squeeze the shank of the shank; this method is more stable, and the main active point of operation is the shoulder joint. It is used for cutting, wide tissue, and strong force incision, such as amputation, tendon incision, and long skin incision.
4. The anti-pick type is a form of conversion of the pen type, and the blade is lifted upwards to avoid damage to the deep tissue; the operation is first pierced and moved to the finger. It is used to cut open organs such as abscess, blood vessel, trachea, common bile duct or ureter, cut off the tissue of the clamp or enlarge the skin incision.

Wrong knife method ( × )
(Left) chopsticks, the position of the hand is too high; (right) the knife is too low

• Regardless of which method of holding the knife, the protruding surface of the blade should be perpendicular to the tissue, and the tissue should be cut layer by layer. Do not use the blade tip to force the operation. The knife is too high and the control is unstable. Too low and hinder the line of sight. .

Transfer of scalpel ( √ )

• When passing the scalpel, the transmitter should hold the back of the joint between the shank and the blade, and send the end of the shank to the operator's hand. The blade should not be pointed at the surgeon to avoid damage.

Second, surgical scissors

The correct way to cut ( √ )

Wrong way to cut ( × )

Several common cut poses (√)

Delivery of surgical scissors (√)

• The transmission of scissors: the operator shows, the middle finger straightens, and the "cut open" action for adduction and abduction, the rest of the fingers flexed to the grip

Third, vascular clamp

Correct gripping method (√)
Wrong grip method (×)
Vascular forceps open ( √ )
Transfer of vascular clamp ( √ )

• The correct law enforcement of the vascular clamp is basically the same as the surgical scissors, and sometimes the mastering method or the tongs can be used, and the method of clamping can be avoided. When the vascular clamp is closed, the two hands move in the same way, but when the vascular clamp is opened, the two-hand operation is inconsistent. When opening, hold the ring of the vascular clamp with the thumb and finger, hold the middle ring and the ring finger at the other ring, and gently open the thumb and ring finger to the top. The transmission of the vascular clamp: the palm of the surgeon is up, the thumb is abducted, and the remaining four fingers are straight and straight, and the transmitter holds the front end of the vascular clamp, and the palm of the handle is tapped to the palm of the operator and passed to the operator.

Fourth, surgeryé•Š

Delivery and practice of surgical fistula ( √ )
Error enforcement method ( × )

• The correct posture is the thumb to the index finger and the middle finger, holding the middle of the two-legged foot, holding the tissue stably and moderately; the wrong execution affects both the flexibility of operation and the control of the clamping force.

Five, needle holder

Holding the needle holder method ( √ )

1. The grasping type is also called mastering method, that is, grasping the needle clamp by hand, the clamp ring is close to the big fish muscle, and the thumb, the middle finger, the ring finger and the little finger are respectively pressed on the clamp handle, and the finger is pressed on the proximal axis of the needle holder. Festival. Use the thumb and the large intermuscular and metacarpophalangeal joints to maintain and open the clasp on the needle holder ring.
2. The button type is traditional law enforcement. It is inserted into the caliper ring with the thumb and ring finger, and the force of the finger movement is used to control the needle holder to close and control the range of motion when opening and closing.
3. The single button type is also called the palm finger method, the thumb is inserted into the clamp ring, the finger is pressed in the front half of the forceps for support guiding, and the other three finger pressure clamp rings are fixed in the palm, the thumb can open and close up and down, and the needle holder is controlled to open. With the close.
4. The thumb and the thumb are pressed against the front half of the forceps, and the thumb and the remaining three fingers are pressed against a handle ring to secure the palm. This method is closed, the loose forceps are easier, and the needle is secure.

(Left) Transfer of the needle clamp ( √ ) The transmitter holds the middle of the needle holder and delivers the handle to the surgeon

Six, stitches and trimming

Holding a needle with a needle clamp ( √ )

Needle clamp knotting method ( √ )

Trimming method ( √ )

• The correct method of thread trimming is that after the operator has finished ligation, the wire is lifted slightly to the left side of the operator. The assistant slides the scissors slightly to the upper edge of the knot, and then cuts the line to the left at a 45° angle. At around 1mm. Such as ligation of large blood vessels, mesenteric tissue and deep bleeding area should be appropriate to leave the tail longer, usually about 2 ~ 3mm, in order to prevent the knot slip.

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